Results from EMERALD-3, a global phase 3 clinical trial, show that adding immunotherapy alongside a commonly utilized liver-directed procedure significantly delayed cancer progression in patients whose liver cancer has spread or cannot be treated with surgery. These findings were presented by Memorial Sloan Kettering Cancer Center (MSK) at this year’s annual American Society of Clinical Oncology (ASCO) meeting.
In the trial (NCT05301842) of more than 760 patients across 22 countries, investigators tested combining the immunotherapy regimen STRIDE (tremelimumab plus durvalumab) with or without lenvatinib, a targeted therapy, alongside transarterial chemoembolization (TACE), a minimally invasive treatment that delivers treatment into liver tumors and restricts their blood supply.
Although TACE has been widely used as a standard treatment for this population, durable disease control has remained a challenge for many patients.
A statistically significant delay in progression free survival (PFS) – nearly 30% - was noted in those patients who received STRIDE, lenvatinib, and TACE compared with those who received TACE alone. This adds to a trend in improvement of overall survival (OS). Improvements in PFS and OS were also reported in patients who received STRIDE plus TACE.
“These data represent a crucial step forward in a disease where progress has been limited,” said Ghassan Abou-Alfa, MD, JD, MBA, PhD(hc), MSK gastrointestinal medical oncologist, trial co-lead investigator, and presenter. “I envision these results will help reshape treatment by introducing systemic dual immunotherapy to embolization based local therapy, with the goal of improving all outcomes.”
EMERALD-3 is awaiting completing maturity, and physicians are continuing to follow their patients to help assess long-term survival outcomes. “Liver cancer is an extremely complex disease because you’re dealing with two problems at once: the cancer itself and the liver damage that often comes along with it,” added Dr. Abou-Alfa. “The best outcomes for our patients will come from multidisciplinary teams continuing to work together and maintain ongoing discussions about the most effective treatment approaches for every patient.”
Study Context and Abstract Details
- 760 patients total (293: STRIDE + lenvatinib + TACE; 175: STRIDE + TACE; 292: TACE alone)
- TACE is primarily utilized to treat intermediate-stage Hepatocellular carcinoma (HCC) when a tumor cannot be surgically removed but is confined to the liver. It has been the standard treatment for more than two decades. In most cases, TACE keeps cancer in check for less than one year, and the median time people live following the treatment is about 2-2.5 years.
- While reported side effects were more common with the added treatments (including high blood pressure, diarrhea, decreased appetite plus weight loss appetite), they aligned with the treatment safety profile.
About Liver Cancer and HCC:
- Liver cancer is the sixth most common cancer worldwide and the third leading cause of cancer death globally with most HCC-related deaths occurring in Africa and the Asia-Pacific region. WHO, ACS
- HCC is the most common form of liver cancer and accounts for approximately 90% of all liver cancer cases. ACS
- In the US, an estimated 42,340 new cases and 30,980 deaths from liver cancer are expected in 2026. ACS
The study was supported by AstraZeneca. See here for ASCO 2026 abstract (LBA4000). Disclosures for Dr. Abou Alfa can be found here.
CONTACT:
Courtney Nowak
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